Superior mesenteric artery syndrome is a rare condition. We present the case of a 27 year old male with a history of progressive early satiety over the past 9 years. The Abdominal CT scan demonstrated gastric distention, an enlarged second and third segment of duodenum, and a narrowing where the SMA joins the aorta. The decision was made to perform a duodenal jejunostomy to bypass the narrow segment. Using the laparoscopic approach we dissected the first and second segments of the duodenum. We approached the third segment of the duodenum by making a window on the transverse mesocolon. Using a combined inframesocolic and supramesocolic approach, the duodenum was completely dissected. We created a duodenotomy using ultrasonic shears. The first loop of the jejunum was brought up to the third segment of the duodenum without tension. A 45mm linear stapler with 3.5 mm staples was used to perform the side-to-side duodeno-jejunostomy. The patient had a good post-operative course and was discharged on post op day 2. At the follow-up visit he had resumed a normal food intake. Superior mesenteric artery syndrome can be treated effectively through a laparoscopic duodeno-jejunostomy using a transmesocolic approach.